Moderated by Renee LeClair
Session Coordinator: Emine Erickan Abali

Presentation 1 - The 3-Step Debriefing System as the Driver of Medical Students Confidence and Learning Process A Randomized-Controlled Trial
Juan David Coellar-Pauta    
Tec de Monterrey

Purpose
High-fidelity simulations train medical students and health professionals for real-life situations. Challenging experiences that require students to apply their knowledge and skills can improve their performance. Likewise, the complex situations faced in simulations improve students' self-confidence and critical thinking. Feedback is one of the main drivers for this. The "Good judgment" or 3-step debriefing system is an effective strategy based on learning opportunities that arise during a clinical simulation. The objective of this study is to identify the role of this debriefing system on self-confidence and knowledge perception during clinical simulation.

Methods
This study enrolled 70 fourth-year Mexican medical students randomly divided into 12 teams. Before the activity, the students answered a Pre-simulation validated survey on self-confidence and knowledge perception. All the teams participated in a standardized high-fidelity clinical simulation. 6 teams received a 3-step debriefing session immediately after the simulation and then answered the Post-simulation survey. The other 6 teams answered the survey before the debriefing session. The results of the Pre and Post-simulation surveys were compared among both groups.

Results
The statistical analysis showed an increase in the average self-confidence and knowledge perception survey score from -1.59 in the control group to 3.9 in the group that received the debriefing session (p-value = 0.001). When testing for the impact on confidence and knowledge independently, the improvement goes from -1.12 to 2.18 (p-value < 0.001) and -0.46 to 1.78 (p-value = 0.008) respectively.

Conclusion
This study demonstrates that an established debriefing technique improves students' self-confidence and learning perception. It shows how crucial it is for students to analyze their mistakes in a healthy learning environment and how this enhances their confidence and learning ability. During medical training many opportunities arise for feedback and the implementation of a validated debriefing technique can make a difference.
 

Presentation 2 - Teaching the Process of Death Certification by Identifying Discrepancies between Clinical and Post-Mortem Examination Cause of Death
Samantha D'Amico    
William Carey University College of Osteopathic Medicine

Purpose
Death certificates influence population-based mortality statistics, which guide disease surveillance and allocation resources. Error rates to 45% have been observed in death certificate completion, with physician inexperience and lack of training cited as causes. Medical students receive limited instruction on death certification. Providing students with a strong foundation in anatomic pathology and introducing the process is crucial as the accuracy of death certificates has a lasting impact on the landscape of public health. 

Methods
We studied the pathology of cadavers in the anatomy lab at William Carey University College of Osteopathic Medicine to compare with the cause of the death on the death certificate. In 2020 and 2021 respectively, 31 and 33 cadavers were examined by medical students guided by a board-certified anatomic and clinical pathologist. Specimens and gross photographs were collected. Clinical diagnosis on the death certificate was compared to gross and microscopic findings. IRB approval was not required due to "Not Human Subjects Research" designation. 

Results
In 2021, cause of death was confirmed in 24 cases with 7 discrepancies among 31 cadavers (22.5% error rate). In 2022, cause of death was confirmed in 25 cases with 8 discrepancies among 33 cadavers (24.2% error rate). 

Conclusions
Error rates observed were lower than previous reports, but reliability and accuracy of cause of death based on clinical diagnosis remains a problem. Limitations include sample size, sampling bias from enrollment in the Anatomical Gifts Program, and no access to medical records of cadavers. Educational interventions beginning during medical school and continuing throughout a physician's career can emphasize the importance of accurate completion and improve the error rate. We recommend medical schools using cadavers for gross anatomy provide their students with similar pathologist-guided experiences to introduce to death certification and provide hands-on experiences with anatomical pathology.

Presentation 3 - Reciprocal Peer Teaching and Learning in the Anatomy Laboratory
Ethan Snow    
University of Nebraska Medical Center

Purpose
With increasing enrollments and demands to teach more content without adding contact hours, reciprocal peer teaching and learning (RPTL) has gained traction as a pedagogy for its efficacy, conservation of faculty time and effort, and similarities to clinical learning. As dissection-based human anatomy laboratories entail a distinctive structure and learning environment, RPTL in the anatomy laboratory offers a unique arrangement of active learning (i.e., dissection) and peer communication (i.e., RPTL via prosection). The objective of the present study was to analyze the effect of RPTL on student learning in the anatomy laboratory.

Methods
Fifty students in a health sciences program at an accredited medical institution were divided into two groups. For each anatomy laboratory, one group dissected and learned from faculty instruction. In the subsequent laboratory, that same group peer taught the alternate group what they had learned and accomplished (&lt;30 minutes) before leaving the alternate group to assume dissector and subsequent teacher roles for that day's content. Laboratory examinations, RPTL facilitation guides, and an end-of-semester course survey assessing student satisfaction and perceived impact of RPTL were administered and analyzed.

Results
Dissection and teaching vs. prosection and passive learning correlated no significant class-wide effect on performance of examination items testing respective content; however, when comparing students in upper vs. lower performance quartiles, notable differences were apparent for these performances, content difficulty, preparation time, and general satisfaction.

Conclusions
RPTL can be an efficient and effective pedagogy in the anatomy laboratory, but dissection and teaching are more likely to benefit upper quartile performers while learning via prosection is more likely to benefit lower quartile performers. When implemented effectively, RPTL can positively impact student psychology, communication, team building skills, attitudes toward learning, and study habits. Outcomes from this study may inform frameworks for teaching and learning in other health sciences programs.

Presentation 4 - Virtual Anatomy Laboratories During COVID -19 and its Impact on Medical Education: A Student Perspective
Varna Taranikanti    
Oakland University William Beaumont School of Medicine

Context
Human cadaveric dissection forms the cornerstone of anatomy education and often helps students develop an interest in surgical fields. However, during the COVID-19 pandemic, most medical schools switched from in-person to virtual anatomy lab experiences. However, it is unknown how it would impact students in their chosen specialty and their readiness for clinical years.

Objectives
This study seeks to investigate the student perception of virtual anatomy lab experiences during the COVID-19 pandemic compared to those who received in-person lab experience and its impact on their clinical years. Methods: An online survey was completed by sixty-eight first-, second-, and third-year medical students at a private, suburban Midwestern medical school. Two-sided t-tests were run.

Results
There was no significant difference between the control group (in-person anatomy) and the experimental group (virtual anatomy) with regard to age or gender breakdown. Both groups had comparable rates of anatomy experience prior to medical school. Though no student experienced both types of anatomy laboratory, the virtual group seemed to perceive that their experience was inferior to an in-person experience. Students in the experimental group indicated that they were less confident in their abilities to answer anatomy questions correctly. However, it did not affect students' perceptions about the relevance of anatomy in choosing a residency specialty.

Conclusions
The results of this study show that while completely virtual anatomy laboratory experiences may be possible under extenuating circumstances such as COVID-19, they are likely not the preferred option for overall student learning. Students who completed an entirely virtual anatomy course felt their experience was inferior, and expressed feeling less confident regarding anatomy and its clinical applications, especially in surgery.